Paget’s Disease of Skull Complicated by Mucocele of Frontal Sinuses

More than sixty years ago Sir James Paget described the bone disease which bears his name. His term, osteitis deformans, which is widely used today seems to me a misnomer; the existence of infection is doubtful and frequently there is no deformity.

In the advanced stages of the disease skeletal changes are striking, with the classic signs of massive head, reduced stature, anteriorly bowed legs, and marked kyphosis. However, advanced cases are uncommon. Less advanced cases in which the disease is localized, often limited to one bone, are seen more frequently. Although the skull has long been considered the site of greatest predilection, the spine and pelvis are frequently involved, as has been demonstrated in recent years by routine x-rays of the gastrointestinal and genitourinary tracts.

Complications. Of the many complications of Paget’s disease the occurrence of fractures from minor trauma is the most common and is often the first symptom of the disease. Neurologic symptoms result from changes in the skull as manifested by the high incidence of deafness due to bony encroachment upon the auditory nerve. Neuralgia involving chiefly the infraorbital and supraorbital branches of the fifth cranial nerve and compression of the spinal cord have also been observed. The relation of malignant tumors of the bone to this disease is not definitely established.

CASE REPORT

A white woman, aged 66, came to the Cleveland Clinic on August 20, 1942 complaining of a discharge of pus from a sinus tract in the midportion of the left upper eyelid. . .